The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Mar 2024
Extent of surgical resection for radiologically subsolid T1N0 invasive lung adenocarcinoma: When is a wedge resection acceptable?
To evaluate whether wedge resection (WR) was appropriate for the patients with peripheral T1 N0 solitary subsolid invasive lung adenocarcinoma. ⋯ WR might be appropriate for patients with invasive lung adenocarcinoma appearing as peripheral GGN ≤2 cm and CTR ≤0.5, but inappropriate for those with invasive lung adenocarcinoma appearing as peripheral GGN between 2 and 3 cm and CTR ≤0.5.
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J. Thorac. Cardiovasc. Surg. · Mar 2024
Staged repair for complete atrioventricular septal defect in patients < 4.0 kg.
This study compared the mortality, left atrioventricular valve-related reoperation, and left atrioventricular valve competence in symptomatic neonates and small infants who underwent staged repair incorporating pulmonary artery banding or primary repair for complete atrioventricular septal defect. ⋯ Compared with primary repair, staged repair for complete atrioventricular septal defect in children weighing less than 4.0 kg resulted in comparable survival and reoperation rates and better left atrioventricular valve competence. Pulmonary artery banding may mitigate secondary left atrioventricular valve regurgitation unless a structural valve abnormality exists. Selective deferred intracardiac repair beyond the neonatal and small-infancy period may still play an important role in low-weight patients.
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J. Thorac. Cardiovasc. Surg. · Mar 2024
Efficacy of del Nido cardioplegia in adult cardiac procedures with prolonged aortic crossclamp time.
Equivalent myocardial protection and clinical outcomes have been shown with the use of del Nido cardioplegia (DC) compared with blood cardioplegia (BC) in adult isolated coronary artery bypass grafting and valve patients. However, its safety and efficacy in cardiac procedures with aortic crossclamp times >90 minutes is still unknown. ⋯ In adult cardiac surgical procedures with aortic crossclamp times >90 minutes, comparable myocardial protection, perioperative mortality and morbidity, and distant survival were observed with the use of DC compared with BC. Higher troponin levels were seen in DC patients with crossclamp times between 150 and 180 minutes, but this was not associated with increased mortality.
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J. Thorac. Cardiovasc. Surg. · Mar 2024
Overall survival in low-comorbidity patients with stage I non-small cell lung cancer who chose stereotactic body radiotherapy compared to surgery.
To evaluate trends in the utilization of stereotactic body radiotherapy (SBRT) and to compare overall survival (OS) of patients with early-stage non-small cell lung cancer (NSCLC) undergoing SBRT versus those undergoing surgery. ⋯ SBRT is being increasingly used to treat early-stage lung cancer in low-comorbidity patients. However, for patients who may be candidates for either treatment, the long-term OS favors surgical management.
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J. Thorac. Cardiovasc. Surg. · Mar 2024
Smaller rectus femoris size measured by ultrasound is associated with poorer outcomes after cardiac surgery.
We sought to evaluate the association of low rectus femoris cross-sectional area (RFCSA) with hospital length of stay and poorer outcomes in patients undergoing cardiac surgery. ⋯ Low RFCSA has a significant association with increased hospital length of stay, morbidity, and nonhome discharge in patients undergoing cardiac procedures.